Neglecting the Eyes and It's CASCADE EFFECT On Joint Attention Abilities In CHILDREN with ASDs

Background: In our previous study (Fadda, Doneddu, Striano, Chessa, Salvago, Frigo, Liberati, 2010), we found quantitative differences in the way children with ASD process static eye-gaze direction: They demonstrated fewer fixations to the eyes region compared to controls but equal fixation to the gaze target (GT). These results indicated that children with ASD might be successful in locating the referent of the gaze due to an atypical pattern of visual attention, involving over-exploration of the visual-field. However, in this previous study, we used static pictures of an adult looking toward an object and therefore we might have underestimated children’s ability to focus on the eyes. Moreover, we did not explore to what extent the reduced focus to the eyes prevents children to develop the ability to produce visual patterns of Joint Attention (JA) when observing complex social scenes.

Objectives:  In this study, we aimed to investigate: 1) the ability to follow a dynamic referential looking in children with ASDs; 2) whether children with ASDs who are able to follow a dynamic referential looking produce visual pattern of JA when exploring a complex social scene.

Methods:  We compared 20 children with ASDs (mean chronological age: 102 mths; sd=32,201), 18 autistics, mean non verbal IQ (Leiter-R)= 64 (sd=17.589), mean verbal IQ (PVT)=69,79 (sd=11,128), with a group of TD controls (10 males) in the preschool years (mean age=59 months; sd=8.44). Children were  tested twice with the Tobii T60 Eye Tracker. In the first test, they observed a video in which an actor looked laterally towards one of two identical objects depicted on eye level next to her face. We  measured the number of fixations on two specific areas of interest: eyes and gaze target (GT). The second video showed an adult and a child sitting at a table, one in front of the other. The adult poured some juice into two glasses, put some sugar into one glass and asked the child: “Which one is for you?”. We counted the number of JA visual patterns (adult-object-child) produced by children during the observation of  the scene.

Results:  The results showed that ASD children looked less to the eyes compared to controls (mean FC  ASD=7,79, sd=3,824; mean FC  TD=10,40, sd=3,992; t=2,084; df=37; p<0.05). However, they were as accurate as controls in locating the GT. Children with ASDs showed also a reduced visual pattern of JA when exploring the social scene (mean JA ASD= 2,42, sd=1,121; mean JA TD=5,05, sd=2,03; t=4,953, df=37, p<0.05).

Conclusions:  These results confirmed the findings in our previous study (Fadda et al., 2010), namely that children with ASDs are able to locate a referential target even though they focus less on the eyes. This is true even when the referential gaze is dynamic (gaze shifting) so the eyes motion might better capture the observers’ attention. Neglecting the eyes seems to have a negative cascading effect on visual patterns of JA attention in children with ASD, confirming that focus on relevant social cues is pivotal for social development.